Expand contact precautions? NO!!!!!!!

The Associated Press has an article today on infection prevention efforts at the University of Maryland Medical Center (Eli's old stomping ground). One of the interventions noted is universal contact precautions in the surgical intensive care unit. My thinking on control of multidrug-resistant pathogens is actually moving in the opposite direction. I think that high rates of hand hygiene compliance (particularly if coupled with standard precautions and a bare-below-the-elbows approach) will be shown to be as effective as contact precautions. Another useful approach may be universal gloving (we have found that to be as effective as contact precautions in the ICU setting). And I really don't think it's reasonable for family members to be required to wear gowns if they are not visiting other patients. However, the article's description of the white coat as a "walking germ" was great!